Health Care Service Firms

Pursuant to Governor Murphy’s Executive Order No. 170, signed on July 31, 2020, please be advised that the requirement to obtain accreditation has been temporarily extended due to the COVID-19 pandemic. The extension provides that you have 60 days following the last day of the public health emergency to provide proof of accreditation with one of the accrediting bodies recognized by the Commissioner of the Department of Human Services under N.J.S.A. 34:8-45.1(c).

P.L. 2020, c. 132, enacted December 14, 2020, revised requirements for the audits that health care service firms must submit. The date by which audits were to be submitted, May 21, 2021, has been changed to December 30, 2022. In addition, the new law established that audits would be required solely from health care service firms either which receive more than $250,000.00 for the provision of New Jersey Medicaid Personal Care Assistance services or which generate more than $10 million in gross income in a year.

The law requires every health care service firm, including those required to submit an audit, to submit a financial statement by December 30, 2022.

On May 21, 2018 the regulations requiring Health Care Service Firms​ to become accredited, were adopted.

This adoption is effective immediately but provides for a 12-month period for Health Care Service Firms to come into compliance.

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Rule Adoption ​​

As you were previously advised, on May 21, 2018 the regulations requiring Health Care Service Firms to become accredited, were adopted.

This NOTICE is to clarify the confusion regarding recipients of Medicaid vs private pay firms.

Please be advised, that if you are a Health Care Service Firm registered with the New Jersey Division of Consumer Affairs, you must be accredited with an accrediting body approved by the Commissioner of the Department of Human Services. (A list of these accrediting bodies can be viewed on the Division’s website at NJConsumerAffairs.gov/hcservice, under “Health Care Service Firms”).

Pursuant to P.L. 2014, c. 29 ALL Health Care Service Firms are to obtain accreditation. The law does not make a distinction between health care service firms that receive Medicaid funding and those that do not. ALL Health Care Services Firms are to obtain accreditation regardless of the medical services they provide or the sources of reimbursement.